Carcinoid heart disease: impact of pulmonary valve replacement in right ventricular function and remodeling

2003 ◽  
Vol 12 (1) ◽  
pp. 84
Author(s):  
H.M. Connolly ◽  
H.V. Schaff ◽  
C.J. Mullany ◽  
M.D. Abel ◽  
P.A. Pellikka
Keyword(s):  
Heart Disease ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Carcinoid Heart Disease ◽  
Disease Impact

scholarly journals Carcinoid Heart Disease: Impact of Pulmonary Valve Replacement in Right Ventricular Function and Remodeling

Circulation ◽  
2002 ◽  
Vol 106 (12_suppl_1) ◽  
Author(s):  
Heidi M. Connolly ◽  
Hartzell V. Schaff ◽  
Charles J. Mullany ◽  
Martin D. Abel ◽  
Patricia A. Pellikka
Keyword(s):  
Heart Disease ◽  
Surgical Treatment ◽  
Beneficial Effect ◽  
Right Ventricular ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Nyha Class ◽  
Pulmonary Valve Replacement ◽  
Carcinoid Heart Disease ◽  
Disease Impact

Background Carcinoid heart disease characteristically affects tricuspid (TV) and pulmonary valves (PV), and TV replacement is helpful in selected patients. There is uncertainty, however, regarding optimal surgical management of PV regurgitation. Methods and Results We reviewed 22 patients having operation for carcinoid heart disease and compared those having TV and PV replacement (n=12), to those who underwent TV replacement and excision of the PV (n=10). Pre- and postoperative right ventricular (RV) size and dysfunction were assessed by consensus of 2 echocardiographers blinded to type of surgical treatment. RV dysfunction was graded as none (0), mild (1), moderate (2), or severe (3). RV size was graded as normal (0), or mild (1), moderate (2), or severe (3) enlargement. Preoperatively, RV size (2.2±0.8 [no PVR]versus 2.7±0.6 [with PVR], P =0.15), RV dysfunction (0.9±0.9 [no PVR]versus 1.4±0.7 [with PVR], P =0.14), and NYHA class were similar in the 2 groups. Postop RV size decreased inpatients with PVR, 2.7±0.6 to 1.7±1.0 ( P =0.008), but did not change appreciably in those without PVR, 2.2±0.8 to 2.3±0.8 ( P =0.67). There was no significant change in RV dysfunction after surgery, 1.4±0.7 to 1.8±0.9 with PVR ( P =0.26) and 0.9±0.9 to 1.6±0.9 without PVR ( P =0.07). Conclusions PV replacement appears to have a beneficial effect on RV size in patients after surgery for carcinoid heart disease. This may have important implications for RV remodeling after PV replacement.

Right Ventricular Function after Pulmonary Valve Replacement in Patients with Tetralogy of Fallot

Radiology ◽  
2004 ◽  
Vol 233 (3) ◽  
pp. 824-829 ◽  
Author(s):  
Alexander van Straten ◽  
Hubert W. Vliegen ◽  
Mark G. Hazekamp ◽  
Jeroen J. Bax ◽  
Paul H. Schoof ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement

scholarly journals Comparison of valvar and right ventricular function following transcatheter and surgical pulmonary valve replacement

2017 ◽  
Vol 13 (1) ◽  
pp. 140-146 ◽  
Author(s):  
Wendy F. Li ◽  
Heidi Pollard ◽  
Mohsen Karimi ◽  
Jeremy D. Asnes ◽  
William E. Hellenbrand ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement

scholarly journals Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bhushan Sandeep ◽  
Xin Huang ◽  
Yuan Li ◽  
Xiaowei Wang ◽  
Long Mao ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Primary Repair ◽  
Pulmonary Valve Replacement ◽  
Rv Function

Abstract Background To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF on coupling. Method RV-PA coupling was measured noninvasively by Ea/Emax ratio from CMRI and ECHO. From CMRI results the patients were divided in two groups, RV-PA coupling and RV-PA uncoupling. Ea/Emax ≤1 was considered for coupling patients and Ea/Emax > 1 for uncoupling patients. Results Ninety patients were uncoupled (Ea/Emax: 1.55 ± 0.46) and 45 were coupled (Ea/Emax: 0.81 ± 0.15). Out of 75 TAP repaired patients 60 were uncoupled RV-PV. In addition, higher pro-BNP is an important factor for uncoupled RV-PV (P = 0.001). CMR evaluation for right ventricular function between uncoupling and coupling were RVEDVi (196.65 ± 63.57 vs. 154.28 ± 50.07, P = 0.001), RVESVi (121.19 ± 51.47 vs. 83.94 ± 20.43, P = 0.001), RVSVi (67.19 ± 19.87 vs. 106.31 ± 33.44, P = 0.001), and RVEF (40.90 ± 8.73 vs. 54.63 ± 4.76, P = 0.001). The increased RVEDVi, RVESVi and RVSVi and decreased RVEF have significant correlation with Ea/Emax. Ea/Emax was also found positively correlated with RVEDVi (P = < 0.05, r = 0.35), RVESVi (P = < 0.001, r = 0.41) and negatively correlated with RVSVi (P = < 0.05, r = 0.22) and RVEF (P = < 0.05, r = 0.78). Conclusions Unfavorable RV-PA coupling is present in post operative TOF patients and it is affected by several factors. Our results explain a new concept of RV-PA interactions as a contributing mechanism for the observed decline in RV function.

scholarly journals Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative Tetralogy of Fallot patients underwent for pulmonary valve replacement

2020 ◽  
Author(s):  
Sandeep Bhushan ◽  
Huang Xin ◽  
Li Yuan ◽  
Wang Xiaowei ◽  
Mao Long ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Primary Repair ◽  
Pulmonary Valve Replacement ◽  
Rv Function

Abstract Background: To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF on coupling.Method: RV-PA coupling was measured noninvasively by Ea/Emax ratio from CMRI and ECHO. From CMRI results the patients were divided in two groups, RV-PA coupling and RV-PA uncoupling. Ea/Emax ≤1 was considered for coupling patients and Ea/Emax >1 for uncoupling patients.Results : 90 patients were uncoupled (Ea/Emax: 1.55±0.46) and 45 were coupled (Ea/Emax: 0.81±0.15). Out of 75 TAP repaired patients 60 were uncoupled RV-PV. In addition, higher pro-BNP is an important factor for uncoupled RV-PV ( P =0.001). CMR evaluation for right ventricular function between uncoupling and coupling were RVEDVi (196.65±63.57 vs. 154.28±50.07, P =0.001), RVESVi (121.19±51.47 vs. 83.94±20.43, P =0.001), RVSVi (67.19±19.87 vs. 106.31±33.44, P =0.001), and RVEF (40.90±8.73 vs. 54.63±4.76, P =0.001). The increased RVEDVi, RVESVi and RVSVi and decreased RVEF have significant correlation with Ea/Emax. Ea/Emax was also found positively correlated with RVEDVi ( P=< 0.05, r =0.35), RVESVi ( P=< 0.001, r =0.41) and negatively correlated with RVSVi ( P=< 0.05, r =0.22) and RVEF ( P=< 0.05, r =0.78).Conclusions: Unfavorable RV-PA coupling is present in post operative TOF patients and it is affected by several factors. Our results explain a new concept of RV-PA interactions as a contributing mechanism for the observed decline in RV function.

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